Epidural analgesia during labour in twin pregnancy

We report on the use of epidural analgesia during labour in 58 out of a total of 234 twin deliveries performed over a five-year period. A comparable control group consisted of 44 twin pregnancies delivered consecutively during the year preceding the introduction of epidural analgesia into our department. Epidural analgesia shortened the mean time of labour and made possible the performance of all necessary instrumental and obstetrical manoeuvres, without additional anaesthesia or adverse effects on the second twin. The epidural group required oxytocin more often due to an increased incidence of hypotonic uterine dysfunction. There was also a considerable increase of instrumental deliveries in the epidural group. The condition of the newborn infants of both groups, evaluated by Apgar score at one minute, was similar, but there was a higher perinatal mortality among pre-term infants delivered under epidural analgesia. Epidural analgesia was found to be an acceptable method of relieving pain in twin labour, but because of the increased necessity to use oxytocin and the relatively high perinatal mortality observed among pre-term infants, further experience is necessary before it can be claimed that this is the method of choice for relief of pain in twin labour.